The human intestinal contains rich and diverse microbiota that utilizes a variety of polysaccharides. The intestinal microflora extends the metabolic functions of the body, obtaining energy from indigestible dietary polysaccharides. It is not only a highly competitive environment but also a comprehensive collaboration for these polysaccharides, as the microbiota work to maximize the energy harvested from them through the intestine. Indigestible dietary polysaccharides help to manage colon health and host health by affecting the gut microbial population. These polysaccharides also influence the metabolic activity of the intestinal microbiota by stimulating the formation of SCFAs. Most of these metabolic activities affect host physiology because the epithelium absorbs secondary metabolites and end products or transports them to the liver, where they could exert other beneficial effects. This article reviews the carbohydrates existing in the human intestine, the regulating actions of indigestible polysaccharides on intestinal microflora, and the molecular basis of the degradation process of these polysaccharides. Practical applications Large deals of researches have shown that indigestible polysaccharides possess an outstanding regulation effect on the intestinal microflora, which indicates that indigestible polysaccharides have the potential to be used as prebiotics in the functional food and pharmaceutical industries. However, it is not clear how gut microbiota metabolizes these dietary polysaccharides, and how the resulting gut metabolites may further affect the intestinal microflora population and metabolism. This paper reviews the indigestible dietary polysaccharides existing in the human intestine, the regulation of polysaccharides on gut microbiota, and the molecular basis of the degradation process of these polysaccharides. This review helps to better understand the relationship between indigestible dietary polysaccharides and intestinal microflora, which will provide powerful evidence for the potential use of these polysaccharides as functional foods.

Objectives: Left ventricular diastolic dysfunction (LVDD) is a prevalent condition among patients with non-insulin dependent diabetes mellitus (NIDDM). The aim of this study was to determine the frequency of the LVDD in patients with NIDDM at a tertiary care cardiac center of Karachi, Pakistan. Methodology: This descriptive cross-sectional study included NIDDM patients without history of ischemic heart disease, on anti-hypertensive medication, diagnosed with valvular heart disease, congenital heart disease, arrhythmias, chronic respiratory illness, or with clinically overt heart failure (HF) or history of HF or concomitant systolic dysfunction. Transthoracic echocardiography was performed and LVDD was diagnosed. Results: A total of 114 patients with NIDDM of less than five years were included in this study. Most of the patients were 41 to 60 years of age with mean age of the 52.23±10.85 years. Out of 114 cases, 58(50.9%) were male. Frequency of LVDD was observed to be 61.4% (70/114). With respect to age groups, rate of LVDD was high in above 60 years of age patients that is 90% (18/20) and it was observed 64.9% (24/37) in 51 to 60 years of age. Rate of LVDD was also high in male patients than female with frequency of 70.7% (41/58) vs. 51.8% (29/56). Conclusion: A significant number of patients with NIDDM were found to have LVDD. Increased frequency of LVDD was observed to be associated with male gender and increased age of the patients.

Objective: To determine the frequency of arrhythmias in patients with acute coronary syndrome (ACS) in a tertiary care hospital, Karachi, Pakistan. Methodology: This cross-sectional study was conducted at cardiology department of a tertiary care hospital of Karachi, Pakistan. A total of 189 consecutive patients of either gender presented with ACS during six months of study period were included. Continuous cardiac monitoring (telemetry) was done to record any arrhythmia within 24 hours of onset of symptoms. Results: 189 patients with ACS were included, 152 patients (80.4%) were males with the mean age of 48.23 ± 6.717 years. This included 95 patients (50.3%) with unstable angina, 36 patients (19.1%) with ST elevation myocardial infarction (STEMI), and 58 patients (30.7%) with Non-STEMI. Arrhythmias were seen in 39 patients (20.6%), most commonly observed type of arrhythmia was premature ventricular contractions (12), atrial fibrillation (nine), ventricular tachycardia (seven), and ventricular fibrillation (five). Conclusion: Arrhythmias were reported in 39 patients from the total, accounting for 20.63% of the entire population. The incidence of cardiac arrhythmia was more in the age group 40-60 years and male population.

Background In underdeveloped countries, coronary artery disease (CAD) has developed into a serious health issue due to the high rates of risk factors such as obesity and smoking amongst the population. This study has been performed to find the rate of multivessel CAD (MVD) and subsequent thrombolysis in myocardial infarction (TIMI) flow grade III in patients undergoing primary percutaneous coronary intervention (PCI). Methods This transverse study was carried out involving 110 patients from the emergency department of the National Institute of Cardiovascular Diseases, Karachi, Pakistan, from August 2015 to March 2016. All patients were diagnosed as ST-segment elevation myocardial infarction (STEMI) and had gone through primary PCI. Pre-procedure angiographic findings regarding the number of vessels involved and post-procedure TIMI flow grade were assessed and analysed.